Postoperative hemodynamic and electrophysiologic evaluation of the interatrial baffle procedure

Sunderland, Cecille O.; Henken, Dale P.; Nichols, G. Michael; Dhindsa, Dharam S.; Bonchek, Lawrence I.; Menashe, Victor D.; Rahimtoola, Shahbudin H.; Starr, Albert; Lees, Martin H.

doi:10.1016/0002-9149(75)90053-3

Cited by 22 publications

(3 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Right-to-left shunting at the site of the pericardial baffle has been demonstrated in one of the patients in group II (patient 18), and in other recent studies from our institution (12). This has also been reported by Stark et al (11) in association with superior vena caval obstruc tion following the Mustard operation.…”

Section: Discussionsupporting

confidence: 82%

Respiratory Characteristics of Blood following the Interatrial Baffle Procedure for Dextro Transposition of the Great Arteries

et al. 1976

Self Cite

View full text Add to dashboard Cite

Five children with D-transposition of the great arteries continued to have an elevated blood 2,3-DPG concentration and a lowered blood oxygen affinity for at least 10 days following corrective surgery. Five of ten children in whom arterial oxygen saturation was elevated at least 6 months following surgery, continued to have saturations of less than 90%. Thus, some postoperative patients appear to have a continuing need for facilitated tissue oxygen availability following the Mustard operation (interatrial baffle procedure).

show abstract

Section: Discussionsupporting

confidence: 82%

Respiratory Characteristics of Blood following the Interatrial Baffle Procedure for Dextro Transposition of the Great Arteries

et al. 1976

Self Cite

View full text Add to dashboard Cite

show abstract

“…The surgical manoeuvres involved in redirecting the venous pathways in either the Mustard or the Senning procedures have profound electrophysiologic consequences that predispose patients to sinus nodal dysfunction and intraatrial reentry. 2,[9][10][11][12][13][14] The baffles created by the surgeon, nonetheless, also produce technical challenges for those who might attempt catheter ablation, specifically because, after the redirection procedures, the critical morphologically right atrial structures that are the target of the electrophysiologist are situated on the pulmonary venous side of the heart. We report here our experience, at three tertiary centres undertaking electrophysiology, the investigation and catheter ablation of patients with atrioventricular nodal reentrant tachycardia after either a Mustard or Senning repair.…”

mentioning

confidence: 99%

The electrophysiology of atrioventricular nodal reentry tachycardia following the Mustard or Senning procedure and its radiofrequency ablation

Greene

Skinner

Dubin

et al. 2005

CTY

View full text Add to dashboard Cite

We describe the electrophysiological studies undertaken in four patients with atrioventricular nodal reentry tachycardia in the setting of concordant atrioventricular and discordant ventriculo-arterial connections (transposition). Radiofrequency ablation was attempted in three, all with success. Clear evidence of dual antegrade pathways through the atrioventricular node was present in only one of the four, but other characteristics of discrete fast and slow pathways into the atrioventricular node were present in all. Atrioventricular nodal reentry tachycardia was inducible in all. In the three patients in whom ablation was attempted, the application of radiofrequency energy to the low medial regions of the systemic venous atrium (morphologically left) consistently caused junctional accelerated rhythm, but these lesions were not successful in eliminating the tachycardia. Successful radiofrequency ablation required a retrograde approach to the region of the slow pathway in the pulmonary venous atrium (morphologically right).

show abstract

“…'8 Electrophysiologic studies have delineated more precisely the location of these abnormalities. [9][10][11][12][13][14][15][16] The prognostic implications of surface electrocardiographic studies are controversial,4 8 and the significance of electrophysiologic studies is speculative. Few data are available on the functional characteristics of the conduction system in the normal child and in the preoperative child with a cardiac defect.…”

mentioning

confidence: 99%

His-Purkinje responses and refractory periods during atrial extrastimulation in children with heart defects.

Wolff¹,

Mehta²,

Tamer³

et al. 1981

Circulation

View full text Add to dashboard Cite

SUMMARY During atrial extrastimulation, split His potentials, prolonged His-to-ventricular (H,V,) intervals and block distal to the His bundle deflection were observed in both preoperative and postoperative children with heart defects. His-Purkinje responses and refractoriness were identified in 31 of 78 (40%) pediatric patients (20 of 51 preoperative and 11 of 27 postoperative) during atrial extrastimulation coupled to sinus and/or paced cycle lengths. Split His potentials were found in 14 patients (eight preoperative and six postoperative) and His bundle relative refractory periods ranged from 250-490 msec. Prolonged H2V2 intervals were found in these and in an additional 16 patients (11 preoperative and five postoperative) and the relative refractory period of the His-Purkinje system ranged from 230-500 msec. Block distal to the His deflection occurred in seven patients (five preoperative and two postoperative) and the effective refractory period ranged from 230-510 msec.Split His potentials, long H2V2 intervals and block distal to the His bundle deflection produced by atrial extrastimulation were found in preoperative as well as postoperative children. These responses probably represent functional electrophysiologic characteristics of the pediatric cardiac conduction system. CONDUCTION DISTURBANCES after surgical repair of congenital cardiac defects have been identified by studies of the scalar ECGs and vectorcardiograms.'8 Electrophysiologic studies have delineated more precisely the location of these abnormalities.9-16 The prognostic implications of surface electrocardiographic studies are controversial,4 8 and the significance of electrophysiologic studies is speculative. Few data are available on the functional characteristics of the conduction system in the normal child and in the preoperative child with a cardiac defect.'7-21 Most electrophysiologic studies in children have concentrated on the conduction characteristics of the sinus node, atrium and atrioventricular (AV) node, for the longer refractory periods of the proximal conducting system often preclude elucidation of the conduction properties of the distal system. Nevertheless, His-Purkinje responses and refractoriness have been described in animals22 and in a limited number of human adults17 23-25 and children',`a s representing normal characteristics and in pathologic settings. 26' 27 Clearly, the limits of "normal" refractoriness must be determined before meaningful judgments may be made concerning management. In this paper, we report the His-Purkinje responses and refractory periods in 31 of 78 pediatric cardiac patients and discuss the clinical implications of these findings in both the preoperative and postoperative patient.

show abstract

Postoperative hemodynamic and electrophysiologic evaluation of the interatrial baffle procedure

Cited by 22 publications

References 25 publications

Respiratory Characteristics of Blood following the Interatrial Baffle Procedure for Dextro Transposition of the Great Arteries

Respiratory Characteristics of Blood following the Interatrial Baffle Procedure for Dextro Transposition of the Great Arteries

The electrophysiology of atrioventricular nodal reentry tachycardia following the Mustard or Senning procedure and its radiofrequency ablation

His-Purkinje responses and refractory periods during atrial extrastimulation in children with heart defects.

Contact Info

Product

Resources

About